A real-time 3-dimensional digital Doppler method for measurement of flow rate and volume through mitral valve in children: A validation study compared.

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A real-time 3-dimensional digital Doppler method for measurement of flow rate and volume through mitral valve in children: A validation study compared with magnetic resonance imaging Shuping Ge, MD, Liping Bu, MD, Honghai Zhang, MS, Erik Schelbert, MD, Michelle Disterhoft, MS, RDCS, Xiangning Li, PhD, Xiaokui Li, MD, David Sahn, MD, Alan Stolpen, MD, PhD, Milan Sonka, PhD Journal of the American Society of Echocardiography Volume 18, Issue 1, Pages 1-7 (January 2005) DOI: 10.1016/j.echo.2004.08.021 Copyright © 2005 American Society of Echocardiography. Terms and Conditions

Figure 1 Real-time 3-dimensional digital Doppler image shows color-encoded velocities of flow from left atrium (LA) to left ventricle (LV) across mitral valve (MV) orifice during diastole in a control participant. Journal of the American Society of Echocardiography 2005 18, 1-7DOI: (10.1016/j.echo.2004.08.021) Copyright © 2005 American Society of Echocardiography. Terms and Conditions

Figure 2 Real-time 3-dimensional digital Doppler (RT3DDD) method. Upper panel, Series of 2-dimensional color Doppler flow maps of flow from left atrium to left ventricle through mitral valve during diastole derived from RT3DDD images. Gaussian control surface is placed at level of mitral valve as shown by yellow arch. Middle panel, Color-encoded velocities from spheric control surface (upper panel) are projected onto planar surface and measurement of flow rate is performed by manually tracing area of color-encoded velocities. Lower panel, Flow rate curve derived from measurements as shown in middle panel and flow volume is derived from area under flow rate curve. Journal of the American Society of Echocardiography 2005 18, 1-7DOI: (10.1016/j.echo.2004.08.021) Copyright © 2005 American Society of Echocardiography. Terms and Conditions

Figure 3 Measurement of flow rate and volume at level of ascending aorta by phase velocity cine (PVC) magnetic resonance image (MRI). A, Gradient echo cine MRI of oblique view showing ascending aorta that is used as reference image to obtain cross sections of ascending aorta (AAo). Magnitude (B) and phase (C) MRI images of ascending aorta in cross sections. Cross section of ascending aorta is manually traced to derive stroke volume by PVC MRI at the ascending aorta (AOSV). Journal of the American Society of Echocardiography 2005 18, 1-7DOI: (10.1016/j.echo.2004.08.021) Copyright © 2005 American Society of Echocardiography. Terms and Conditions

Figure 4 Measurement of stroke volume by left ventricular (LV) volumetric magnetic resonance imaging (MRI) (LVSV). Series of LV short-axis slices from mitral valve annulus (left upper panel) to apex (right lower panel) are obtained using gradient echo cine MRI technique (FIESTA) during end systole and end diastole. Endocardial borders are traced manually to derive LVSV. Journal of the American Society of Echocardiography 2005 18, 1-7DOI: (10.1016/j.echo.2004.08.021) Copyright © 2005 American Society of Echocardiography. Terms and Conditions

Figure 5 Pearson and Bland-Altman analysis of stroke volume at the ascending aorta measured by phase velocity cine magnetic resonance image (MRI) compared with stroke volume by left ventricular volumetric magnetic resonance imaging. Journal of the American Society of Echocardiography 2005 18, 1-7DOI: (10.1016/j.echo.2004.08.021) Copyright © 2005 American Society of Echocardiography. Terms and Conditions

Figure 6 Pearson and Bland-Altman analysis of stroke volume measurements by real-time 3-dimensional digital Doppler at mitral valve orifice compared with measurements by phase velocity cine magnetic resonance imaging at the ascending aorta. Journal of the American Society of Echocardiography 2005 18, 1-7DOI: (10.1016/j.echo.2004.08.021) Copyright © 2005 American Society of Echocardiography. Terms and Conditions

Figure 7 Pearson and Bland-Altman analysis of stroke volume measurements by real-time 3-dimensional digital Doppler at mitral valve orifice compared with measurements by left ventricular volumetric magnetic resonance imaging. Journal of the American Society of Echocardiography 2005 18, 1-7DOI: (10.1016/j.echo.2004.08.021) Copyright © 2005 American Society of Echocardiography. Terms and Conditions